Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy: study protocol for a randomised controlled trial

Ingwersen, Kim Gordon; Christensen, Robin; Sørensen, Lilli; Jørgensen, Hans R. I.; Jensen, Steen Lund; Rasmussen, Sten; Søgaard, Karen; Juul-Kristensen, Birgit

doi:10.1186/s13063-014-0544-6

Cited by 28 publications

(35 citation statements)

References 64 publications

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“…The primary endpoint was 12 weeks after baseline. Details on the trial are published in Ingwersen et al 24 …”

Section: Methodsmentioning

confidence: 99%

“…Patients were excluded if they had resting pain >40 mm on a visual analog scale (VAS; range, 0-100; 0 = no pain), 5 <90° active elevation of the arm, a full-thickness rotator cuff tear (verified by ultrasound), a corticosteroid injection within the previous 6 weeks, or competing diagnoses. 24 …”

Section: Methodsmentioning

confidence: 99%

“…Good compliance was defined as attending at least 4 of 6 visits to the physical therapist and completing >80% of the exercises at home (reported in the diary). 24 …”

Section: Methodsmentioning

confidence: 99%

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Three Months of Progressive High-Load Versus Traditional Low-Load Strength Training Among Patients With Rotator Cuff Tendinopathy: Primary Results From the Double-Blind Randomized Controlled RoCTEx Trial

Ingwersen

Jensen

Sørensen

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Progressive high-load exercise (PHLE) has led to positive clinical results in patients with patellar and Achilles tendinopathy. However, its effects on rotator cuff tendinopathy still need to be investigated.Purpose:To assess the clinical effects of PHLE versus low-load exercise (LLE) among patients with rotator cuff tendinopathy.Study Design:Randomized controlled trial; Level of evidence, 1.Methods:Patients with rotator cuff tendinopathy were recruited and randomized to 12 weeks of PHLE or LLE, stratified for concomitant administration of corticosteroid injection. The primary outcome measure was change from baseline to 12 weeks in the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, assessed in the intention-to-treat population.Results:A total of 100 patients were randomized to PHLE (n = 49) or LLE (n = 51). Mean changes in the DASH questionnaire were 7.11 points (95% CI, 3.07-11.16) and 8.39 points (95% CI, 4.35-12.44) in the PHLE and LLE groups, respectively; this corresponded to a statistically nonsignificant adjusted mean group difference of −1.37 points (95% CI, −6.72 to 3.99; P = .61). Similar nonsignificant results were seen for pain, range of motion, and strength. However, a significant interaction effect was found between the 2 groups and concomitant corticosteroid use (P = .028), with the largest positive change in DASH in favor of PHLE for the group receiving concomitant corticosteroid.Conclusion:The study results showed no superior benefit from PHLE over traditional LLE among patients with rotator cuff tendinopathy. Further investigation of the possible interaction between exercise type and corticosteroid injection is needed to establish optimal and potentially synergistic combinations of these 2 factors.Registration:NCT01984203 (ClinicalTrials.gov identifier): Rotator Cuff Tendinopathy Exercise Trial (RoCTEx).

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“…The primary endpoint was 12 weeks after baseline. Details on the trial are published in Ingwersen et al 24 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Three Months of Progressive High-Load Versus Traditional Low-Load Strength Training Among Patients With Rotator Cuff Tendinopathy: Primary Results From the Double-Blind Randomized Controlled RoCTEx Trial

Ingwersen

Jensen

Sørensen

et al. 2017

Orthopaedic Journal of Sports Medicine

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“…The selected essential exercises generally strengthen the posterior rotator cuff muscles (supraspinatus, infraspinatus, and teres minor) and load the shoulder into an elevated position, consistent with current trial evidence [35,36]. The GRASP trial thus included these exercise types as an essential component of both the progressive exercise and best-practice advice exercise programmes.…”

Section: Phase 2: Intervention Developmentmentioning

confidence: 74%

Development and implementation of the physiotherapy-led exercise interventions for the treatment of rotator cuff disorders for the ‘Getting it Right: Addressing Shoulder Pain’ (GRASP) trial

et al. 2020

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Objectives The Getting it Right: Addressing Shoulder Pain (GRASP) trial is a large-scale, multicentre, 2 × 2 factorial randomised controlled trial investigating clinical and cost-effectiveness of a progressive exercise programme versus best-practice advice, with or without corticosteroid injection, for treating people with rotator cuff disorders. Here we describe the development, implementation and details of the physiotherapy-led interventions. Methods Medical Research Council guidance for developing complex interventions were used, taking into account clinical guidelines, expert and patient opinion, research evidence, current practice variation, and deliverability. A stakeholder meeting of 26 experts, clinicians, researchers, and patient representatives was used to design key components of the interventions. Stakeholders prioritised strengthening posterior rotator cuff muscles and using practical, easy-to-do exercises. The interventions were designed to be deliverable across the UK National Health Service. Results Progressive exercise consists of up to six sessions with a physiotherapist over 16 weeks. The best-practice advice consists of one face-toface session with a physiotherapist with substantially greater reliance on self-management. Both interventions include self-management advice, home-exercise instruction, and behaviour-change strategies to target exercise adherence. All participants receive a Participant Information Booklet. The best-practice advice intervention is a self-guided system of progressively challenging exercises, with demonstration videos and written materials. The progressive exercise intervention has a wider range of exercise options, and greater flexibility for tailoring, progression, supervised practice and feedback. Conclusion GRASP has recruited 708 participants and will provide high quality evidence to inform management of people with shoulder pain due to a rotator cuff disorder. Results are anticipated in 2020.

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“…Contudo, não há um consenso que estabeleça diretrizes detalhadas sobre programas de exercícios físicos resistidos endereçados a pessoas diagnosticadas com síndrome do impacto subacromial, como o caso da tendinose do manguito rotador 10 . Sendo assim, esta revisão propôs-se a apresentar evidências baseadas na literatura científi ca sobre os possíveis efeitos do treinamento resistido como forma de tratamento conservador da tendinose no manguito rotador.…”

Section: Introductionunclassified

Efeitos do treinamento resistido em indivíduos com tendinose no manguito rotador – uma revisão de literatura

Toigo

2018

SDH

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RESUMOIntrodução: O ombro é considerado um local frequentemente acometido por lesões esportivas, especialmente nas modalidades que envolvem rebatidas e arremessos em razão da grande demanda biomecânica. As lesões de manguito rotador, entre as quais destaca-se a tendinose, podem ser complicadas de tratar em esportistas, porque, em muitas vezes, o quadro doloroso não corresponde aos diagnósticos por imagem e os indivíduos com esse tipo de lesão, muitas vezes, conseguem praticar esporte sem relato de dor. Objetivo: Esta revisão propôs-se a apresentar evidências baseadas na literatura científi ca sobre os possíveis efeitos do treinamento resistido como forma de tratamento conservador da tendinose no manguito rotador. Método: Foram selecionados e analisados artigos de periódicos arbitrados presentes em bancos de dados acadêmicos EBSCO e Pubmed entre os anos de 2007 e 2017. Resultados e conclusões: Todos os resultados encontrados mostraram efeitos positivos do treinamento resistido nas variáveis dor, amplitude de movimento e função muscular, inclusive nos que realizaram follow-up, verifi cando que, mesmo após algum tempo sem treinar, os efeitos benéfi cos mantiveram-se. Dessa forma, o treinamento resistido parece ser uma alternativa de tratamento conservador para o alívio da dor, aumento da amplitude de movimento e melhora da função do manguito rotador em indivíduos com tendinose no manguito rotador.Palavras-chave: Tendinopatia; Manguito Rotador; Treinamento Resistido. ABSTRACT Introduction:The shoulder is considered a site frequently aff ected by sports injuries, especially in the modalities involving batting and throwing due to the great biomechanical demand. Rotator cuff lesions, such as tendinosis, can be complicated to treat in sports persons, because often the painful picture does not correspond to the imaging diagnoses and because individuals with this type of lesion often can practice the modality without pain. Objective: the aim of this study was to present evidences based on the scientifi c literature on the possible eff ects of resistance exercise as a form of conservative treatment of tendinosis in the rotator cuff . Method: papers were selected and analyzed from refereed journals on specifi c academic databases, EBSCO and Pubmed, between 2007 and 2017. Results and conclusions: All the results showed positive eff ects of resistance training on the variables pain, range of motion and muscle function, including those who performed Revista Saúde e Desenvolvimento Humano -ISSN 2317-8582 Efeitos do treinamento resistido em indivíduos com tendinose no manguito rotador -uma revisão de literaturaEff ects of resistance training on individuals with rotator cuff tendinosis -a review Efectos del entrenamiento resistido en individuos con tendinosis en el manguito rotador -una revisión de literatura http://dx.

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Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy: study protocol for a randomised controlled trial

Cited by 28 publications

References 64 publications

Three Months of Progressive High-Load Versus Traditional Low-Load Strength Training Among Patients With Rotator Cuff Tendinopathy: Primary Results From the Double-Blind Randomized Controlled RoCTEx Trial

Three Months of Progressive High-Load Versus Traditional Low-Load Strength Training Among Patients With Rotator Cuff Tendinopathy: Primary Results From the Double-Blind Randomized Controlled RoCTEx Trial

Development and implementation of the physiotherapy-led exercise interventions for the treatment of rotator cuff disorders for the ‘Getting it Right: Addressing Shoulder Pain’ (GRASP) trial

Efeitos do treinamento resistido em indivíduos com tendinose no manguito rotador – uma revisão de literatura

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